Barriers and facilitators to initial and continued attendance at community-based lifestyle programmes among families of overweight and obese children: a systematic review

The success of childhood weight management programmes relies on family engagement. While attendance offers many benefits including the support to make positive lifestyle changes, the majority of families referred to treatment decline. Moreover, for those who do attend, benefits are often compromised by high programme attrition. This systematic review investigated factors influencing attendance at community-based lifestyle programmes among families of over-weight or obese children. A narrative synthesis approach was used to allow for the inclusion of quantitative, qualitative and mixed-method study designs. Thirteen studies met the inclusion criteria. Results suggest that parents provided the impetus for programme initiation, and this was driven largely by a concern for their child's psychological health and wellbeing. More often than not, children went along without any real reason or interest in attending. Over the course of the programme, however, children's positive social experiences such as having fun and making friends fostered the desire to continue. The stigma surrounding excess weight and the denial of the issue amongst some parents presented barriers to enrolment and warrant further study. This study provides practical recommendations to guide future policy makers, programme delivery teams and researchers in developing strategies to boost recruitment and minimise attrition.

Integrated soil fertility management in eastern and western Africa: The role of knowledge and innovation systems, its adoption and impact

The rise in population growth, as well as nutrient mining, has contributed to low agricultural productivity in Sub-Saharan Africa (SSA). A plethora of technologies to boost agricultural production have been developed but the dissemination of these agricultural innovations and subsequent uptake by smallholder farmers has remained a challenge. Scientists and philanthropists have adopted the Integrated Soil Fertility Management (ISFM) paradigm as a means to promote sustainable intensification of African farming systems. This comparative study aimed: 1) To assess the efficacy of Agricultural Knowledge and Innovation Systems (AKIS) in East (Kenya) and West (Ghana) Africa in the communication and dissemination of ISFM (Study I); 2) To investigate how specifically soil quality, and more broadly socio-economic status and institutional factors, influence farmer adoption of ISFM (Study II); and 3) To assess the effect of ISFM on maize yield and total household income of smallholder farmers (Study III). To address these aims, a mixed methodology approach was employed for study I. AKIS actors were subjected to social network analysis methods and in-depth interviews. Structured questionnaires were administered to 285 farming households in Tamale and 300 households in Kakamega selected using a stratified random sampling approach. There was a positive relationship between complete ISFM awareness among farmers and weak knowledge ties to both formal and informal actors at both research locations. The Kakamega AKIS revealed a relationship between complete ISFM awareness among farmers and them having strong knowledge ties to formal actors implying that further integration of formal actors with farmers’ local knowledge is crucial for the agricultural development progress. The structured questionnaire was also utilized to answer the query pertaining to study II. Soil samples (0-20 cm depth) were drawn from 322 (Tamale, Ghana) and 459 (Kakamega, Kenya) maize plots and analysed non-destructively for various soil fertility indicators. Ordinal regression modeling was applied to assess the cumulative adoption of ISFM. According to model estimates, soil carbon seemed to preclude farmers from intensifying input use in Tamale, whereas in Kakamega it spurred complete adoption. This varied response by farmers to soil quality conditions is multifaceted. From the Tamale perspective, it is consistent with farmers’ tendency to judiciously allocate scarce resources. Viewed from the Kakamega perspective, it points to a need for farmers here to intensify agricultural production in order to foster food security. In Kakamega, farmers with more acidic soils were more likely to adopt ISFM. Other household and farm-level factors necessary for ISFM adoption included off-farm income, livestock ownership, farmer associations, and market inter-linkages. Finally, in study III a counterfactual model was used to calculate the difference in outcomes (yield and household income) of the treatment (ISFM adoption) in order to estimate causal effects of ISFM adoption. Adoption of ISFM contributed to a yield increase of 16% in both Tamale and Kakamega. The innovation affected total household income only in Tamale, where ISFM adopters had an income gain of 20%. This may be attributable to the different policy contexts under which the two sets of farmers operate. The main recommendations underscored the need to: (1) improve the functioning of AKIS, (2) enhance farmer access to hybrid maize seed and credit, (3) and conduct additional multi-locational studies as farmers operate under varying contexts.

Local Understandings of Soil Fertility, Rainfall and Conservation Agriculture in Laikipia, Kenya: A Qualitative Analysis.

Conservation Agriculture (CA) is mostly referred to in the literature as having three principles at the core of its identity: minimum soil disturbance, permanent organic soil cover and crop diversity. This farming package has been described as suitable to improve yields and livelihoods of smallholders in semi-arid regions of Kenya, which since the colonial period have been heavily subjected to tillage. Our study is based on a qualitative approach that followed local meanings and understandings of soil fertility, rainfall and CA in Ethi and Umande located in the semi-arid region of Laikipia, Kenya. Farm visits, 53 semistructured interviews, informal talks were carried out from April to June 2015. Ethi and Umande locations were part of a resettlement programme after the independence of Kenya that joined together people coming from different farming contexts. Since the 1970–80s, state and NGOs have been promoting several approaches to control erosion and boost soil fertility. In this context, CA has also been promoted preferentially since 2007. Interviewees were well acquainted with soil erosion and the methods to control it. Today, rainfall amount and distribution are identified as major constraints to crop performance. Soil fertility is understood as being under control since farmers use several methods to boost it (inorganic fertilisers, manure, terraces, agroforestry, vegetation barriers). CA is recognised to deliver better yields but it is not able to perform well under severe drought and does not provide yields as high as ‘promised’ in promotion campaigns. Moreover, CA is mainly understood as “cultivating with chemicals”, “kulima na dawa”, in kiswahili. A dominant view is that CA is about minimum tillage and use of pre-emergence herbicides. It is relevant to reflect about what kind of CA is being promoted and if elements like soil cover and crop rotation are given due attention. CA based on these two ideas, minimum tillage and use of herbicides, is hard to stand as a programme to be promoted and up-scaled. Therefore CA appears not to be recognised as a convincing approach to improve the livelihoods in Laikipia.